Chapter 32 Obstetrics and Neonatal Care

Which of the following question is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes

"Have you had a sonogram?"

a newborn infant will usually begin breathing spontaneously within _____ seconds following birth

15 to 30

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:

16 hours.

an abortion occurs when the fetus and placenta deliver before

20 weeks

Preeclampsia MOST commonly occurs after the _____ week of gestation

30th

if a baby is born at 7:52 the second Apgar score should be calculated at

7:57

you have just delivered a baby boy. His body is pink but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resist attempts to straighten his legs. His Apgar score is

8

you have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. what should you do next?

Assess the brachial or umbilical pulse

Which of the following statements regarding gestational diabetes is correct?

In some cases, women with gestational diabetes require insulin injections

Which of the following processes occurs during ovulation?

The inner lining of the uterus thickens in preparation for implantation.

Which of the following statements regarding the placenta is correct?

The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.

Which of the following occurs during true labor?

Uterine contractions become more regular.

Which of the following statements regarding a breech presentation is MOST correct

a breech presentation occurs when the buttocks are presenting part

spina bifida is a developmental defect in which

a portion of the spinal cord or meninges protrudes outside of the vertebrae

Braxton-Hicks contractions are characterized by:

alleviation of pain with movement or changing positions.

A history of pelvic inflammatory disease or tubal ligations increase a woman's risk for

an ectopic pregnancy

during your visual inspection of a 19-year old woman in labor you see the baby's head crowning at the vaginal opening. what should you do?

apply gentle pressure to the baby's head as it delivers

positive-pressure ventilations

are not common interventions used to stimulate spontaneous respirations in the newborn

You are assessing a 25-year old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions you should

assess her for crowning

Upon delivery of an infant's head you note that the umbilical cord is wrapped around its neck. you should

attempt to slip the cord gently over the infants head

the third stage of labor begins when the

baby is expelled from the vagina

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's:

belly button.

The vagina and the neck of the uterus comprise the:

birth canal.

the ONLY indications for placing your gloved finger in the vagina during delivery are

breech presentation and prolapsed umbilical cord

The umbilical cord:

carries oxygen to the baby via the umbilical vein.

The onset of labor begins with:

contractions of the uterus.

Which of the following is an indication of imminent birth?

crowning of the baby's head

Placenta previa is MOST accurately defined as

development of the placenta over the cervical opening

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience

easier breathing

If a pregnant patient requires spinal immobilization you should secure her to the backboard and then

elevate the right side of the board with rolled towels or blankets

After a baby is born it is important to

ensure that it is thoroughly dried and warmed

following delivery of a full-term baby you have properly cared for the baby and have clamped and cut the umbilical cord. during transport you note that the mother is experiencing moderate vaginal bleeding. you should

firmly massage the uterine fundus with a circular motion

in contrast to a full-term infant a premature infant

has an even proportionately larger head

A precipitous labor and delivery is MOST common in women who

have delivered a baby before

signs and symptoms of preeclampsia include

headache and edema

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy?

increased respiratory rate and decreased respiratory reserve

The amniotic fluid serves to:

insulate and protect the fetus.

The leading cause of maternal death during the first trimester of pregnancy is

internal bleeding caused by a ruptured ectopic pregnancy

body size

is not a component of the Apgar Score

profound tachycardia

is not a fetal complication associated with drug- or alcohol addicted mothers

return of contractions following delivery of the baby

is not considered an obstetrical emergency

The term primigravida refers to a woman who:

is pregnant for the first time.

a nuchal cord is defined as an umbilical cord that

is wrapped around the baby's neck

you have just delivered a premature baby. Your assessment reveals that he is breathing adequately however his heart rate is 90 beats/min. you should

keep him warm and provide ventilatory assistance

which of the following statements regarding twins is correct

most twins are born within 45 minutes of each other

When preparing a pregnant patient for delivery you should position her

on a firm surface with hips elevated 2" to 4"

Most medical models base a pregnant woman's due date:

on the first day of her last menstrual cycle.

A woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic tachycardic, and hypotensive. In addition to administering 100% oxygen, you should

place her in a left lateral recumbent position

your 22- year old patient is in active labor. upon visual inspection you note that the infant's leg is protruding from the vagina. appropriate management of this situation includes

placing the mother supine with here head down and pelvis elevated

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because:

pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because

pregnant patients have an overall increase in blood volume

following delivery of a pulseless and apneic infant who has a foul odor skin sloughing and diffuse blistering you should

provide emotional support to the mother

if a newborn's heart rate is less than 60 beats/min following delivery you should

provide ventilations for 30 seconds

upon delivery of the baby's head you note that its face is encased in the unruptured sac . you should

puncture the sac and suction the baby's mouth and nose

while examining a woman in labor you see the umbilical cord protruding from the vagina. you should

push the infant's head away from the cord

Eclampsia is MOST accurately defined as

seizures that result from severe hypertension

When determining the frequency of contractions you should time the contractions form the

start of one to the start of the next

During delivery of the baby's head you should suction the mouth before the nose because

suctioning the nose first may cause the baby to gasp and aspirate fluid

when the mother is experiencing a contraction you should instruct her to

take quick short breaths

The presence of thick meconium in the amniotic fluid indicates

that the baby's airway may be obstructed

During delivery it is MOST important to position your partner at the mother's head because

the mother may become nauseated and vomit

Abruptio Placenta occurs when

the placenta prematurely separates from the wall

Supine hypotensive syndrome occur when

the pregnant uterus compresses the inferior vena cava

The term "bloody show" is defined as:

the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

vigorous suctioning of a newborn's airway is indicated if

there is meconium in the amniotic fluid

general treatment guidelines when caring for a woman with traumatic vaginal bleeding include

transporting to an appropriate facility

From what internal female organ is the fetus expelled during delivery?

uterus

an infant is considered to be premature if it

weighs less than 5 lb or is born before 36 weeks gestation